Practice Economics

VA health care reform signed into law


 

References

President Obama has signed a bill that promises to give veterans faster access to medical care, in part by reimbursing services given by physicians and hospitals outside the Veterans Affairs health care system.

The Veterans Access, Choice and Accountability Act of 2014 makes $10 billion available through the "Veterans Choice Fund." The money is available until the funds are spent or until August 2017, whichever comes first.

U.S. Senate

The bill, signed into law by President Obama on August 7, promises to give veterans faster access to medical care.

Under the act, the VA is required to authorize non-VA care for any veteran who is enrolled in the VA system as of Aug. 1 or who is a newly discharged combat veteran if they can’t get an appointment at a VA medical facility within 30 days, or if they live more than 40 miles from the nearest VA medical facility.

The law also will take a closer look at care delivered within the VA, by requiring an independent assessment and establishing a congressional commission that will evaluate access to care throughout the system. It also provides $5 billion to hire new physicians and other medical staff to help increase access to care.

"This will not and cannot be the end of our effort," said President Obama at a signing ceremony Aug. 7 at Ft. Belvoir, Va. He also said that change would not happen overnight. "Implementing this law will take time," said the president.

Physician groups praised the legislation when lawmakers reached a compromise on the act, leading to passage by the House July 30, followed by the Senate July 31.

The American Medical Association supported the bill "because it is an important step to connecting veterans with physicians who can help them right now," AMA President Robert M. Wah said in a statement.

There are a number of reasons to be pleased with the law, added Dr. Reid Blackwelder, president of the American Academy of Family Physicians. Payment will be negotiated at rates not to exceed Medicare, except in very rural areas, he noted in a statement. The law also establishes 1,500 new residency slots in the VA system, with priority given to primary care and mental health.

"While the challenges associated with the current and future physician workforce within the VA will take time to fully resolve, this legislation will allow America’s civilian physicians to fill the void right away, ensuring that those who have served their country will no longer have to wait for primary care," said Dr. Blackwelder.

The American Psychiatric Association also applauded the increase in residency slots, and it welcomed the news that the VA will be able to prioritize hiring each year based on its identification of the five biggest staffing shortage areas. "In 2012, the VA Office of the Inspector General identified recruiting and retaining psychiatrists as the VA’s greatest challenge in the mental health area," said APA President Paul Summergrad in a statement.

"This legislation puts in place several actions to directly address that shortage, and will result in many more veterans having timely access to needed psychiatric services," he said.

The two congressmen who helped shepherd the legislation through the House and Senate also said they were gratified.

"I am pleased President Obama has finally recognized what we have been telling administration officials for years: that VA’s widespread and systemic lack of accountability is jeopardizing the health of veterans and contributing to all of the department’s most pressing problems," said Rep. Jeff Miller (R-Fla.), chairman of the House Committee on Veterans Affairs, in a statement.

"To prevent history from repeating itself, President Obama must become personally involved in solving VA’s many problems," Rep. Miller said. "A good place for him to start would be to meet with family members and veterans who have been struck by the VA scandal, order the department to cooperate with the congressional committees investigating VA, and force [the Department of Defense] and VA to work together to establish a joint electronic health record integrated across all DoD and VA components."

"In a dysfunctional Congress, I’m glad we accomplished something significant for veterans," Sen. Bernie Sanders (I-Vt.) said in a statement. This legislation will go a long way toward ending unacceptably long waiting times for veterans to access health care, and allow the VA the resources to hire the doctors, nurses, and other medical staff it needs to address these problems over the long term."

aault@frontlinemedcom.com

On Twitter @aliciaault

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